The Globe and Mail examines the sustainability of Sierra Leone’s free health care system, writing, “The reform has been hugely successful and the death rate has dropped sharply. … [But t]he country’s hospitals are overwhelmed with new patients, the drug supply can’t keep up, the medical staff are overloaded, and it’s unclear if the $36-million program would survive without foreign donations.” According to the newspaper, “The principle of free health care is a sharp break from earlier ideology” that supported “‘cost recovery’ — a system of user fees in hospitals” — which leaders thought “would generate money to fix their badly underfunded health systems.” However, the user fees “were widely criticized, they failed to solve the funding problems, and they created a new barrier to health care” for many without the means to pay, the Globe and Mail writes.

“At least 10 African countries have now moved to some form of free health care in recent years, and others are introducing low-priced insurance schemes. Some, such as Burundi, have reported an impressive rise in the number of hospital births after eliminating fees. The most spectacular results have been in Sierra Leone, where the challenges were steepest,” the newspaper continues. “Health experts are hoping that Sierra Leone could be a model for solving the global crisis in maternal and child health,” the Globe and Mail notes, adding, “But now the country must battle to keep the new system afloat” (York, 5/9). The Globe and Mail also features a gallery of photographs taken inside Sierra Leone’s largest maternal hospital (Power, 5/9).